Search Results (523)

Background/Objectives: Pubertal maturation encompasses hormonal, somatic, and metabolic alterations that may influence pulmonary function in children with asthma. We evaluated the correlates of pulmonary function in pediatric asthma using sex-stratified analyses of pubertal stage, BMI z-score, asthma control (ACQ-6), and HDL cholesterol levels on FEV1, FVC, and the FEV1/FVC ratio (% predicted, NHANES III). Methods: A cross-sectional study was conducted with 118 children and adolescents with asthma (74 males and 44 females). The Tanner stages were categorized as pre-/early (I–II), mid (III), and late (IV). No participant had reached Tanner stage V at recruitment, and the reference category was composed predominantly of Tanner II participants; therefore, the pubertal contrast reflected early- versus mid-/late-pubertal physiology rather than a strictly prepubertal-versus-pubertal comparison. We performed hierarchical linear regression with bias-corrected and accelerated bootstrap inference (5000 replicates) for each sex and for all participants combined, complemented by a formal sex × predictor interaction test. Results: Mid- and late puberty were independently associated with reduced FEV1% and FVC% (β −0.25 to −0.31), without affecting the FEV1/FVC ratio. Sex-stratified analyses were exploratory and identified apparently divergent predictor sets by sex: in males, the pubertal stage was significant in FEV1% and FVC% (β −0.30 to −0.42), whereas the BMI z-score diminished the FEV1/FVC ratio (β = −0.274). In females, FEV1% was associated with HDL-c (β = 0.463), BMI z-score (β = 0.429), and ACQ-6 score (β = −0.306); the female FEV1/FVC% model showed a substantial apparent effect (Cohen’s f² = 0.508), with ACQ-6 score and HDL-c as primary associated variables. The formal sex × predictor interaction test in the combined sample, however, did not reach statistical significance (ΔR² = 0.037; p = 0.178), indicating that the sex-differential patterns observed in the stratified models were not confirmed as effect modifications. Conclusions: Sex-stratified exploratory analyses in this pediatric asthma cohort identified apparently divergent patterns of associations in males and females; however, the formal interaction test was not statistically significant, indicating that these stratified differences were not confirmed and require validation in adequately powered prospective cohorts. These findings identify HDL-c, body composition, and symptom control as candidate correlates of pulmonary function, with potential sex-related differences warranting further investigation. Full article

Background: Preschool wheezing is common, but distinguishing transient wheezing from early persistent asthma remains difficult. Oscillometric techniques, including impulse oscillometry (IOS), may provide objective prognostic information. Objective: To systematically review longitudinal studies assessing whether oscillometric measurements obtained at preschool age are associated with later asthma-related outcomes or lung function impairment. Methods: PubMed, Scopus, and MEDLINE (via EBSCOhost) were searched from inception to 28 February 2026. Eligible studies included preschool-aged children or closely related early-childhood populations assessed with IOS or forced oscillation technique (FOT), longitudinal follow-up, and later asthma-related or spirometric outcomes. Two reviewers independently screened studies, extracted data, and assessed risk of bias with QUIPS. Owing to substantial heterogeneity, findings were synthesized qualitatively. Results: Seven longitudinal cohort studies, encompassing 1077 children, met the eligibility criteria; baseline oscillometry was performed between ages 2 and 7 years, and follow-up ranged from 1 to 10 years. Short-term classification and longer-term prognostic studies were interpreted separately. Resistance-based indices, particularly R5, showed the most consistent associations with later asthma-related outcomes and lower subsequent spirometric indices, including FEV₁ and FEV_1/FVC. Most studies were at moderate risk of bias, and some reports came from related cohorts. Conclusions: Preschool oscillometry may provide complementary physiological information to assess asthma risk in symptomatic or high-risk preschool-aged children, particularly through resistance-based measures. However, evidence remains limited, heterogeneous, and insufficient to support a single validated cutoff, routine screening of apparently healthy children, or routine stand-alone prognostic use. Full article

Background/Objectives: Scoliosis is a three-dimensional deformity involving coronal curvature, axial rotation, and sagittal imbalance, which may alter thoracic geometry and reduce ventilatory capacity. Traditional two-dimensional radiographic measures incompletely represent the complexity of axial rotation, and the apical vertebra is not always the most rotated vertebra. We aimed to determine whether computed tomography (CT)-derived three-dimensional vertebral rotation indices, particularly global rotational asymmetry between main and compensatory curves, are associated with pulmonary function impairment in a large heterogeneous scoliosis cohort. Methods: We retrospectively reviewed 250 patients with scoliosis who underwent full-spine CT and spirometry within a 1-year interval (2013–2023). Vertebral rotation was measured using the Aaro–Dahlborn method. Rotation indices included apical rotation (R(Apex)), averaged apical rotation across the apical vertebra and adjacent levels (R(Avg)), and rotational asymmetry defined as the absolute difference between rotation in the main and compensatory curves (ΔR(M–C)). Pulmonary function outcomes were FVC (L), FEV1 (L), FVC% and FEV1%. Pearson correlation and multivariate linear regression, adjusted for age, sex, height, and weight, were performed; sensitivity analyses, additionally adjusted for upright Cobb angle and thoracic kyphosis (TK) to evaluate whether ΔR(M–C) provided independent explanatory information, and subgroup analyses by etiology were performed. Results: The cohort had a mean age of 15.6 ± 5.7 years; 49.6% were female. All rotation indices showed significant negative correlations with pulmonary function in the overall cohort. ΔR(M–C) showed the strongest associations with FVC% (r = −0.66) and FEV1% (r = −0.64), as well as with absolute volumes (FVC, r = −0.59; FEV1, r = −0.58). In adjusted multivariate analyses, models incorporating ΔR(M–C) consistently demonstrated the highest explanatory performance compared with models based on R(Apex) or R(Avg). Subgroup analysis revealed the strongest associations in neurofibromatosis-related scoliosis (r = −0.87) and congenital scoliosis (r = −0.71). Associations were attenuated in neuromuscular subtypes and did not reach statistical significance in SMA. In sensitivity analyses adjusting for Cobb angle and thoracic kyphosis, ΔR(M–C) retained a robust independent association with FVC% (unstandardized B = −0.82 percentage points per 1°, 95% CI −0.98 to −0.66; p < 0.001; partial F = 103, p < 0.001), while neither Cobb angle nor TK remained statistically significant after adjustment for ΔR(M–C); comparable patterns were observed across FEV1%, FVC, and FEV1. Conclusions: CT-derived global rotational asymmetry between the main and compensatory curves is strongly associated with pulmonary function impairment in scoliosis and demonstrates superior explanatory performance to single-level rotation indices and retains independent explanatory value after adjustment for conventional 2D radiographic parameters (Cobb angle and thoracic kyphosis). Incorporating a CT-derived metric may complement traditional two-dimensional assessments for functional risk stratification. Full article

Background: With the increasing use of cigarettes and electronic nicotine delivery systems (ENDS) in young adults, growing concern exists regarding lung health among university students. While the adverse respiratory effects of smoking are well established in older populations, early functional changes among young adults remain less well studied. Identifying such changes in this vulnerable population is crucial due to the risk of detrimental long-term health effects and the role of implementing early preventive measures. This study aims to compare the effects of nicotine use, sex, and body mass index (BMI) on the spirometric lung function parameters, including FEV₁, FVC, and FEV₁/FVC ratio, of smokers (including cigarette, ENDS, shisha, and midwakh users) and non-smokers in a university population. Methods: This cross-sectional study was conducted at Ajman University, United Arab Emirates. A convenience sample of 652 smokers and non-smokers students was initially recruited voluntarily, of whom 630 participants met the spirometry acceptability criteria and were included in the final analysis. Lung function was assessed using spirometry performed according to the guidelines of the American Thoracic Society and European Respiratory Society. Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and the FEV₁/FVC ratio were recorded and expressed as percentages of predicted values based on Global Lung Function Initiative reference equations. Lung function parameters were compared according to smoking status, sex, and BMI. Results: A total of 630 students were included (60.5% males; the majority aged 20–22 years). The prevalence of smoking was 28.9% and was significantly higher among males than females (38.6% vs. 14.1%; OR = 3.86, p < 0.001). Smokers demonstrated a significantly lower FEV₁/FVC ratio compared with non-smokers (0.84 ± 0.07 vs. 0.86 ± 0.07, p < 0.001), despite slightly higher predicted FEV₁ and FVC values. Males exhibited higher predicted lung volumes than females, whereas females had higher FEV₁/FVC ratios (p < 0.001). Lung function varied significantly across BMI categories (p < 0.001), with increasing BMI associated with higher predicted lung volumes but lower FEV₁/FVC ratios. Stratified analysis showed that male smokers had the lowest FEV₁/FVC ratios, while female non-smokers had the highest. Conclusions: Smoking, sex, and BMI significantly influenced lung function in this cohort. Smokers demonstrated reduced FEV₁/FVC ratios, indicating early airflow limitation. Males were more likely to smoke and had higher lung volumes, while females showed higher FEV₁/FVC ratios. Increasing BMI was associated with higher lung volumes but lower FEV₁/FVC ratios. These findings suggest that early pulmonary changes may occur in young adults, highlighting the importance of early screening, careful interpretation of spirometry, and the implementation of targeted public health interventions to reduce nicotine use, promote smoking cessation, and support lung health among university students. Full article

Background: The increased detection of small peripheral non-small-cell lung cancers through screening programs has renewed interest in parenchyma-sparing sublobar resection as an alternative to lobectomy. While oncologic non-inferiority has been established, the functional impact of sublobar resection remains a key consideration. Methods: We reviewed evidence from landmark randomized controlled trials, recent meta-analyses, observational studies, and updated clinical practice guidelines. Results: In the CALGB 140503 trial, sublobar resection demonstrated only a modest 2-percentage-point advantage in preserved FEV1 and FVC at 6 months compared with lobectomy, a difference considered clinically marginal in patients with normal baseline pulmonary function. A meta-analysis of five randomized controlled trials confirmed that sublobar resection was associated with significantly less reduction in postoperative lung function. A retrospective study demonstrated that segmentectomy preserved FEV1 at 84.2% of preoperative values versus 69.9% after lobectomy at one year, with particular benefit observed in elderly patients and those with COPD. Volumetric analyses showed greater contralateral compensatory lung expansion after lobectomy, partially offsetting functional differences. Notably, patient-reported outcomes, including physical function, dyspnea, and cough scores, showed no significant differences between groups up to two years postoperatively. The ERS/ESTS 2025 guideline noted that segmentectomy is associated with reduced long-term dyspnea deterioration and may improve patients’ ability to tolerate subsequent treatments. Conclusions: Sublobar resection offers a statistically significant but modest advantage in spirometric lung function preservation over lobectomy for early-stage NSCLC. This benefit may be most clinically relevant in patients with compromised baseline pulmonary function, COPD, or a potential need for future treatments. Full article

Background: Seasonal haze from biomass burning in northern Thailand frequently elevates PM_2.5 above national and WHO standards, while evidence on short-term lung function changes in exposed populations remains limited. Method: This longitudinal study evaluated changes in lung function in 130 adults before and after the haze season from December 2023 to May 2024 in San Pa Thong District, Chiang Mai Province. Spirometry was conducted following ATS/ERS standards. Demographic and health-risk data were gathered using validated Thai questionnaires addressing diabetes, cardiovascular, and chronic obstructive pulmonary disease risk categories. Results: A significant reduction in the FEV₁/FVC ratio was observed, from 85.3% to 82.4% (p = 0.001) after the haze period, while the proportion of participants with FEV₁/FVC < 70% increased from 2.3% to 6.9% (p = 0.031). No statistically significant independent predictors were identified in multivariable analysis. Greater reductions were observed in older adults, low-income individuals, and those at moderate to high diabetes risk. Conclusions: These findings suggest modest changes in spirometry parameters during the seasonal haze period. The observed reduction in FEV₁/FVC should be interpreted cautiously and may reflect early functional variation rather than confirmed airway obstruction. Although the magnitude of change was relatively small, the findings highlight the potential value of ongoing respiratory monitoring and early detection strategies in haze-affected regions. Full article

Spirometry is widely regarded as the clinical gold standard for quantifying lung function. It plays a central role in the diagnosis and management of cardiopulmonary disorders, including asthma and chronic obstructive pulmonary disease (COPD). However, the procedure relies on a forceful and often stressful expiratory maneuver that may cause patient discomfort and require substantial effort, frequently necessitating active coaching and trained personnel to ensure reproducible measurements. In this paper, we present the Digital Spirometry Patch (DSP), a soft, flexible, wearable patch capable of estimating lung function parameters by utilizing low-effort breathing maneuvers. Eighteen participants performed low-effort and forceful breathing maneuvers while wearing the DSP to collect tracheal sound and chest movement signals for spirometric parameter estimation using elastic net and simple linear regression. Using leave-one-subject-out cross-validation, the elastic net models achieved RMSEs of 0.668 L, 0.224 L, and 0.428 L/s for FVC, FEV₁, and PEF, respectively, using low-effort breathing maneuvers, and 0.499 L, 0.304 L, and 0.891 L/s using forceful exhalation maneuvers. These results demonstrate the potential of the DSP as a wearable, low-effort alternative for estimating lung function outside of conventional spirometry settings. Full article

Background/Objectives: Childhood non-cystic fibrosis (non-CF) bronchiectasis is clinically heterogeneous. We aimed to describe fractional exhaled nitric oxide (FeNO) levels in affected children and examine associations with etiology, spirometry, and CT-defined disease extent. Methods: This single-center prospective observational study included 100 clinically stable children aged 6–18 years with CT-confirmed non-CF bronchiectasis evaluated between September 2014 and December 2015. FeNO was measured before spirometry using an online single-breath electrochemical technique. Chest CT was reviewed at the lobar level, with the lingula counted separately, and disease extent was summarized by the number of involved lobar regions. Associations were assessed using Spearman correlation and non-parametric tests. Results: Mean age was 14.9 ± 2.0 years, 55% were male, and mean FeNO was 20.9 ± 14.0 ppb. FeNO correlated positively with FEV1 (% predicted), FVC (% predicted), and FEF25–75 (% predicted) (all p < 0.01). FeNO was higher in males and adolescents than in females and younger children, respectively. FeNO did not differ by CT-defined lobar extent. It was lower in primary ciliary dyskinesia than in asthma overlap. Overall, 82% of the cohort received an ICS-containing maintenance regimen and household tobacco smoke exposure was present in 58%. Conclusions: FeNO was associated with selected functional indices and etiologic subgroups, but not with CT-defined structural extent, suggesting a greater role in clinical phenotyping than in reflecting radiologic burden. Rather than reflecting overall disease severity, FeNO may be more relevant as a marker of T2-leaning airway inflammatory phenotype in selected children with non-CF bronchiectasis. These findings should be interpreted as exploratory and hypothesis-generating, particularly for etiologic subgroup comparisons and for FeNO interpretation in the setting of treatment and environmental confounding. Full article

Background/Objectives: The Global Lung Initiative (GLI) 2022 race-neutral spirometry reference equations were introduced to improve interpretability across populations; however, their performance in Middle Eastern adolescents remains insufficiently validated. This study evaluated the applicability of GLI-2022 among healthy Jordanian adolescents. Methods: Healthy adolescents were recruited from secondary schools across multiple Jordanian cities (July–November 2025). Spirometry was performed according to ATS/ERS standards using a single device and standardized procedures. GLI-2022 predicted values and z-scores were derived for forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC. Calibration was assessed using mean (SD) z-scores and the proportion below the lower limit of normal (LLN; z < −1.645). Agreement between measured and predicted values was examined using Bland–Altman methods. LLN-based pattern classifications were compared with those obtained using the local reference equation and GLI-2012. Results: A total of 921 adolescents (482 males, 439 females; mean age 15.7–16.0 years) were included. GLI-2022 produced positive mean z-scores for FEV1 (0.51–0.73) and FVC (0.51–0.69), with low proportions below LLN for both indices (<2% in each sex), indicating underestimation of predicted lung volumes. Exact binomial testing confirmed that the observed proportions below LLN for FEV1 and FVC were significantly lower than the expected 5% in both sexes (all p < 0.001). The FEV1/FVC ratio showed smaller deviations (mean z 0.07–0.19), with 4.1% of females and 5.8% of males below LLN, and these proportions did not differ significantly from 5% (female p = 0.444; male p = 0.402). Mean observed-minus-predicted biases for FEV1 were +0.185 L in females and +0.306 L in males, and for FVC were +0.224 L and +0.351 L, respectively; FEV1/FVC bias was −0.15 percentage points in females and +0.60 percentage points in males. LLN-based pattern classification showed 98.7% overall agreement with the local equation and 99.7% with GLI-2012; concordance for obstructive and possible restrictive patterns was 93.5% and 100.0%, respectively. Conclusions: In healthy Jordanian adolescents, GLI-2022 appears to underestimate predicted FEV₁ and FVC, yielding upward-shifted z-scores and fewer volume indices below LLN, while the ratio is less affected. Although LLN-based pattern classification was largely preserved, population-specific validation remains necessary before routine clinical adoption of GLI-2022 in Jordanian adolescents; extrapolation to other Middle Eastern adolescent populations should await additional regional validation. Full article

Background: Industrial activities may contribute to airway diseases, particularly chronic obstructive pulmonary disease (COPD) and asthma, which are major respiratory health problems with geographically variable prevalence. The objective of this study was to assess the prevalence of COPD and asthma and to examine factors associated with impaired pulmonary function among workers and residents of the Navanakorn Industrial Zone, Thailand. Methods: A cross-sectional study was performed from September 2025 to January 2026 among adults aged ≥18 years who were employed in or residing within the Navanakorn Industrial Zone. Data collected included demographic characteristics, comorbidities, respiratory symptoms, chest radiographic findings, and spirometric parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and bronchodilator responsiveness (BDR). COPD was defined as the presence of respiratory symptoms in conjunction with at least one risk factor and a post-bronchodilator FEV₁/FVC < 70%. Asthma was defined by the presence of respiratory symptoms with a positive BDR. Results: Among the 373 participants (65.4% female; mean age 55.0 ± 13.6 years), the prevalence of COPD and asthma was 4.3% and 5.4%, respectively. Abnormal chest radiographic findings were present in 8.6%, while abnormal pulmonary function was identified in 30.8%. Lung function abnormalities included airway obstruction (12.9%), restrictive patterns (9.7%), mixed defects (2.1%), and small airway disease (6.2%). A positive BDR was detected in 2.4% of participants. Multivariable logistic regression analysis demonstrated older age, male sex, a history of asthma, and the presence of chest tightness as independent predictors of abnormal lung function. Conclusions: COPD and asthma were prevalent among individuals working or living in the industrial zone, and abnormal pulmonary function—particularly obstructive defects—was common. Older age, male sex, a history of asthma, and respiratory symptoms were associated with a greater risk of lung function impairment, underscoring the importance of targeted surveillance and preventive strategies in industrial environments. Full article

Introduction: Emphysema is frequently observed in patients with fibrosing interstitial lung diseases (f-ILDs), leading to the clinical entity known as combined pulmonary fibrosis and emphysema (CPFE). This study aimed to evaluate the utility of airwave oscillometry (AOS) in detecting small-airway dysfunction (SAD) in patients with CPFE. Due to the coexistence of both restrictive and obstructive airway disease, spirometry is comparatively less sensitive in detecting airflow limitations in this population. Methods: A cohort of 52 patients with CPFE was recruited from Monaldi Hospital, Naples, between January and September 2023. Pulmonary function tests—including spirometry, body plethysmography, and single-breath diffusing capacity for carbon monoxide (DLCO)—were performed at baseline and following bronchodilator administration. Patients with normal FEV1/FVC ratios underwent airwave oscillometry (AOS) to assess respiratory system resistance (Rrs) and reactance (Xrs), with SAD defined as an R5–R19 value greater than 0.07 kPa·s·L⁻¹. Results: AOS-defined SAD was present in 40.4% (21/52) of the cohort. The R5–R19 value in the SAD group was 0.13 ± 0.05 kPa·s·L⁻¹, which can be compared to 0.04 ± 0.02 kPa·s·L⁻¹ in patients without SAD. Patients with SAD were more likely to be undergoing maintenance bronchodilator therapy (16/21; 76.2%) than those without SAD (8/31; 25.8%) (p = 0.015). Fourteen CPFE patients met the criteria for bronchial responsiveness. CPFE patients who responded to bronchodilators had lower R5-R19 values than non-responders (0.04 ± 0.02 vs. 0.09 ± 0.06 kPa·s·L⁻¹; p = 0.04). Discussion: Although AOS parameters did not significantly change following bronchodilator administration, this study underscores the value of AOS in detecting peripheral airway dysfunction, which may be under-recognized by conventional spirometry. Conclusions: AOS shows promise as a diagnostic adjunct for identifying SAD in CPFE patients and may complement standard pulmonary function testing in clinical practice. Further multicenter studies with larger cohorts are warranted to validate these findings and investigate the longitudinal impact of SAD on disease progression and treatment outcomes in CPFE. Full article

Introduction: Pediatric asthma is the inflammatory condition with the highest burden of chronic disease in children. Awareness of the undesirable effects of modern lifestyles, including sedentary behavior and eating habits associated with Western diets, has led to novel approaches in clinical practice. Current concerns focus on the possibility of non-pharmacological intervention to achieve better disease control and normal lung function in these children. Method: In this narrative review, we analyzed current information on the influence of dietary patterns on lung function. The aim was to clarify the extent to which current knowledge provides arguments for applying certain dietary measures to asthma patients in order to optimize lung function. We conducted research in the literature to evaluate the impact of Western diet, Mediterranean diet, and micronutrients status on lung function. We also focused on how maternal diet during pregnancy can influence lung function in offspring. Results: We found a positive impact on lung function in children who adhere to the Mediterranean diet, in contrast to the Western diet which is related to low asthma control. Deficits of micronutrients like selenium, zinc, iron, and vitamin D are linked to impaired lung function. Maternal intake of fiber, vitamin A, vitamin E, zinc, and selenium during pregnancy is correlated with better FEV1 and FVC. However, current information on this topic is controversial, and there is no clear data on intervention measures in clinical practice. Conclusions: Evaluation and clear recommendations of diet could contribute to a better management of children with asthma. Full article

Background/Objectives: Shoulder arthroscopies are commonly conducted in orthopedic practice. The interscalene brachial plexus block (ISB) is regarded as the “gold standard” for postoperative analgesia in shoulder surgeries. The serratus posterior superior intercostal plane block (SPSIPB) was introduced as an innovative treatment for addressing thoracic and shoulder discomfort. This study aims to examine the effects of SPSIPB and ISB techniques on postoperative pain levels, opioid intake, and respiratory function measures in patients having shoulder arthroscopy. Methods: Patients were divided into two groups. In the ISB group, 15 mL of fluid containing 0.25% bupivacaine was applied between interscalene muscles, while in the SPSIPB group, 30 mL of 0.25% bupivacaine was applied in the fascial plane between the serratus posterior superior muscle and the intercostal muscles. Results: There were no statistically significant differences in demographic characteristics (p > 0.05). VAS scores were statistically lower in the ISB group compared to the SPSIPB group at rest at 1, 2, 4, 8, 12, and 24 h postoperatively in the PACU (p < 0.05). VAS scores were also lower in the ISB group compared to the SPSIPB group during active movement at 1, 2, 4, 8, and 12 h postoperatively in the PACU (p < 0.05). Twenty-four-hour fentanyl consumption was lower in the ISB group compared to the SPSIPB group (407.50 ± 169.32 μg and 767.50 ± 178.00 μg, respectively, p < 0.001). The decrease in FEV₁ and FVC was higher in the ISB group compared to the SPSIPB group (p < 0.001). Conclusions: ISB effectively relieves pain during shoulder arthroscopic procedures; however, while SPSIPB is considered a more advantageous option in terms of respiratory safety, it may not provide adequate analgesia on its own. Full article

Background: Identifying multimodal interventions to counteract age-related physiological decline is a critical public health priority. This study investigated the impact of an 8-week Mat Pilates intervention (MPT) on the interplay between core stability, pulmonary function, and cardiorespiratory fitness in older adults, specifically examining the mechanistic link between trunk stabilization and respiratory mechanics. Methods: Twenty older adults (18 females, 2 males; age 60—77 years) were randomized (stratified by sex, age, and baseline stability) into an MPT group (n = 10; 60-min sessions, 3×/week) or a control group (CON, n = 10). Primary outcomes included core stability (plank test), functional flexibility (sit-and-reach; back-scratch), pulmonary function (FVC, FEV₁, FEV₁/FVC, FEF_25–75%, MVV), and cardiorespiratory fitness (6-min walk test; 6MWT). Results: Post-intervention, the MPT group demonstrated significant improvements in core stability, flexibility, and all pulmonary variables (FVC, FEV₁, FEF_25–75%, MVV) compared to the CON group (p < 0.001). A significant reduction in body weight was also observed (p < 0.001). Notably, MPT participants achieved superior 6MWT distances and reduced perceived exertion (p = 0.006). Correlation analysis revealed strong positive associations between core stability gains and pulmonary function (r = 0.892, p < 0.01), supporting the mechanistic link between trunk stabilization, enhanced ventilatory mechanics, and functional aerobic capacity. Conclusions: Mat Pilates is a potent intervention for older adults, facilitating a physiological synergy where core strengthening optimizes pulmonary function and cardiorespiratory endurance. These findings suggest MPT is a comprehensive modality for maintaining musculoskeletal and respiratory health, proving superior to habitual activity alone in promoting functional independence. Full article

Background: Low-dose computed tomography (LDCT) lung cancer screening (LCS) frequently identifies emphysema in high-risk smokers. However, the extent to which CT-detected emphysema reflects underlying physiological impairment remains uncertain. We evaluated whether spirometry can detect functional abnormalities in this population beyond structural imaging findings. Methods: This cross-sectional study included 323 individuals with LDCT- detected emphysema and no lung cancer or prior chronic respiratory diseases within a screening cohort (n = 3076). Participants underwent pre-bronchodilator spirometry and symptom assessments (COPD Assessment test (CAT) and Modified Medical Research Council (mMRC) Dyspnea Scale). Pre-bronchodilator airflow limitation was defined as forced expiratory volume in one second to forced vital capacity ratio (FEV₁/FVC) < 0.70. Small airways dysfunction was defined by ≥2 reduced mid-expiratory flow parameters (<60% predicted). Flow–volume curve morphology was assessed qualitatively. Results: Pre-bronchodilator airflow limitation was observed in 45.2% of participants, predominantly mild. Small-airway dysfunction was present in 52%, and an abnormal flow–volume curve morphology in 67.5%. Notably, functional abnormalities were frequently observed despite preserved FEV₁. Symptom burden was low, with only 7.7% of participants reporting clinically significant symptoms. Functional impairments often overlapped and were common in minimally symptomatic individuals. Conclusions: In a lung cancer screening (LCS) cohort with CT-detected emphysema, functional abnormalities are frequently observed, including in individuals with preserved FEV₁ and minimal symptoms. Spirometry provides additional physiological insight beyond structural imaging; however, these findings are descriptive and should not be interpreted as diagnostic of COPD. Further studies are needed to determine their clinical relevance. Full article